太阳三日已发汗，若吐若下若温针，不解致逆成坏证，观其脉证犯何经，难辨阴阳
六经证，重困垂危莫可凭，惟用独参煎冷服，鼻上津津有汗生。
【注】太阳病三日，已发汗不解，若吐、若下、着温针，苟或相当即成解证。如其不
当，不但病不解，或因而致逆变成坏怔，当观其脉证，知犯何经之逆。如汗后亡阳、渴
躁谵语，下后寒中、结胸痞硬，吐后内烦腹满，温针后黄、衄、惊、狂之类，随证治之
可也。甚或脉微欲绝，神昏不能言，循衣摸床，叉手冒心等、重困垂危，难辨阴阳，六
经莫可凭之怔。此时此际，惟用人参煎汤，徐徐冷服，以待其机。倘得鼻上津津有汗，则
为可生之兆也。
表证宜汗太阳经，无汗发热恶寒风，头项强痛身体痛，若出自汗表虚明。
【注】表证，谓寒邪在表，无汗发热，恶寒恶风，头项强痛，身体痛也。太阳经主表，
故曰表证。有是证无汗者，皆属表实。虽有是证，若自汗出者，皆属表虚，未可轻汗，即
有风邪，只宜桂枝汤解肌可也。表实无汗，重者麻黄汤主之。轻者麻桂各半汤主之。时有
汗时无汗者，桂枝二麻黄一汤主之，表实躁热甚者，三黄石膏汤主之。微者，大青龙汤
主之。不躁有热者，桂枝二越婢一汤主之。以上表证，不必悉具，亦不论日之多寡，但见
有头痛恶寒一、二证，即为表未罢，虽有里证，当先解表。表解已，乃可攻之，临证者
不可不详辨也。详太阳篇。
太阳病经过三天，如果已经发汗，或者使用了催吐、泻下、温针等治疗方法，但病情没有解除，导致误治而变成坏证。此时应当观察患者的脉象和症状，判断病邪侵犯了哪一经络，但这往往难以辨别阴阳属性。
六经的症状表现复杂，患者处于极度困顿、生命垂危的状态，常规方法难以凭借。此时只能使用独参汤（单用人参煎煮的汤剂），冷却后服用，如果看到鼻头上微微出汗，说明还有生机。
【注】太阳病三天，已经发过汗但病未解，如果再用催吐、泻下或温针等方法，如果用法恰当，就会成为痊愈的征象。如果用法不恰当，不仅病不能好，反而可能因为误治导致逆证，变成坏证。这时应当观察脉象和症状，知道是哪一经发生了逆乱。比如发汗后出现亡阳、口渴烦躁、说胡话；泻下后出现中焦虚寒、结胸、心下痞硬；催吐后出现心中烦闷、腹部胀满；温针后出现发黄、鼻出血、惊悸、发狂等情况，应当根据具体症状进行治疗。甚至有的患者脉象微弱几乎摸不到，神志昏迷不能说话，手无意识地抓摸衣被床沿，双手交叉护住心胸等，处于极度困顿、生命垂危、难以辨别阴阳、无法依据六经辨证治疗的危重状态。在这个关键时刻，只有用人参煎汤，慢慢冷服，以等待转机。如果得到鼻头微微出汗，这就是可以生存的征兆。
表证适宜用发汗法治疗，这是太阳经受邪的表现。如果没有汗、发热、怕风怕冷、头项强痛、身体疼痛，如果是自然出汗，则属于表虚证。
【注】表证，是指寒邪在体表，表现为无汗、发热、怕冷怕风、头项强痛、身体疼痛。太阳经主管体表，所以称为表证。有这些症状且无汗的，都属于表实证。虽然有这些症状，但如果自然出汗的，都属于表虚证，不可以轻易发汗。即使有风邪，只适宜用桂枝汤来解肌发表。表实证无汗，严重的用麻黄汤主治。轻的用麻黄桂枝各半汤主治。有时有汗有时无汗的，用桂枝二麻黄一汤主治。表实证伴有严重躁热的，用三黄石膏汤主治。躁热轻微的，用大青龙汤主治。不躁动但有热的，用桂枝二越婢一汤主治。以上表证，不需要所有症状都具备，也不论患病天数多少，只要见到头痛、恶寒中的一两个症状，就认为是表证未解。即使有里证，也应当先解表。表证解除后，才可以攻里。临证时不可不详细辨证。详见《伤寒论》太阳篇。
After three days of Taiyang disease, if sweating therapy has already been applied, or if emesis, purgation, or warm needle therapy has been used, but the condition remains unresolved, iatrogenic errors may lead to complex complications (Bad Conditions). At this stage, one must observe the pulse and symptoms to determine which meridian is affected; however, distinguishing between Yin and Yang patterns becomes difficult.
The manifestations of the Six Meridians are complex, with patients in a state of extreme exhaustion and critical danger, making conventional diagnostic methods unreliable. In such cases, only Dushen Decoction (Decoction of Single Ginseng) should be administered cold. If slight perspiration appears on the tip of the nose, it indicates that life can still be saved.
[Annotation] After three days of Taiyang disease, if sweating therapy has been applied but the illness persists, and subsequently emesis, purgation, or warm needles are employed: if these treatments are appropriate, they will lead to recovery. If inappropriate, not only will the illness remain unresolved, but iatrogenic errors may cause adverse reactions, leading to Bad Conditions. One must then observe the pulse and symptoms to identify which meridian has suffered from the error. For instance, after sweating, symptoms of Yang collapse (Wang Yang), thirst, irritability, and delirium may occur; after purgation, middle Jiao deficiency-cold, chest binding (Jie Xiong), or epigastric fullness and hardness may arise; after emesis, internal vexation and abdominal distension may appear; after warm needle therapy, jaundice, nasal bleeding, fright, or mania may ensue. Treatment should be tailored to these specific symptoms. In severe cases where the pulse is faint and nearly imperceptible, consciousness is lost, speech is impossible, the patient unconsciously grasps at clothing or bedrails, or crosses hands over the heart, presenting a critical state of exhaustion where Yin and Yang cannot be distinguished and Six Meridian differentiation fails, only Ginseng decoction administered slowly and coldly should be used to await a turning point. If slight perspiration appears on the nose, it signifies a sign of potential survival.
Exterior syndromes are suitable for sweating therapy, typically involving the Taiyang Meridian. Symptoms include absence of sweat, fever, aversion to wind and cold, stiffness and pain in the head and nape, and body ache. If spontaneous sweating occurs, it clearly indicates an Exterior Deficiency pattern.
[Annotation] An Exterior Syndrome refers to pathogenic cold located at the exterior, manifesting as absence of sweat, fever, aversion to cold and wind, stiffness and pain in the head and nape, and body ache. The Taiyang Meridian governs the exterior, hence the term "Exterior Syndrome." Cases presenting these symptoms without sweat belong to Exterior Excess. However, even with these symptoms, if spontaneous sweating is present, it belongs to Exterior Deficiency, and gentle sweating should not be attempted lightly. Even if Wind pathogens are present, only Guizhi Tang (Cinnamon Twig Decoction) should be used to release the muscle layer. For Exterior Excess with no sweat, severe cases are treated with Mahuang Tang (Ephedra Decoction), while mild cases are treated with Mahgui Gehan Tang (Mahuang and Guizhi Half-Decoction). Cases with intermittent sweating are treated with Guizhi Er Mahuang Yi Tang (Guizhi Twice-Mahuang Once Decoction). For Exterior Excess with severe restlessness and heat, Sanhuang Shigao Tang (Three-Yellow Gypsum Decoction) is used. For mild restlessness with heat, Da Qinglong Tang (Major Blue Dragon Decoction) is indicated. For heat without restlessness, Guizhi Er Yuebi Yi Tang (Guizhi Twice-Yuebi Once Decoction) is prescribed. For the above Exterior Syndromes, it is not necessary for all symptoms to be present, nor does the number of days matter. As long as one or two symptoms such as headache and aversion to cold are observed, the Exterior syndrome is considered unresoved. Even if Interior symptoms exist, the Exterior must be resolved first. Only after the Exterior is resolved can Interior pathogens be attacked. Clinicians must distinguish these details carefully. See the Taiyang Chapter for details.